How old is too old? A contribution to the discussion on age limits for assisted reproduction technique access

Abstract

In 2012, the Czech Republic established the women's age limit for access to assisted reproduction techniques at age 49 years. In this paper, the acceptability of this age limit from the children's perspective in the Czech Republic is assessed. Although the necessity of balancing the interests of parents and children is acknowledged, little research has taken children's interests into account. We have attempted to map out 'children's interests', asking older children and adolescents (aged 11-25 years) how old they would prefer their parents to be: Czech respondents would prefer to have younger parents. This finding is consistent with the optimal biological childbearing age rather than with the current postponement to a later age. So far, assisted reproduction techniques have been largely regarded as a medical treatment justifying the current women's age limit of 49 years. Had the children's perspective been taken into account, this age limit might have been lower than 49 years. We propose that reproductive health policy should adequately reflect multiple perspectives as an integral part of a multi-layered support system of a society.

Live-birth rates in very poor prognosis patients, who are defined as poor responders under the Bologna criteria, with nonelective single embryo, two-embryo, and three or more embryos transferred

“…W here the line should be drawn and women with low pregnancy chances should no longer be offered access to IVF with use of their own oocytes has remained undetermined among medical professionals (1,2) as well as among the lay public (3). Our center has advocated a policy of almost brutal directness in discussing pregnancy and live-birth chances but at the same time has offered patients an almost unrestricted right of self-determination in choosing poor chances with own eggs over better pregnancy and live-birth chances with young donor oocytes after detailed informed consent (4,5).…”

The realization of fertility intentions in the context of childbearing postponement: comparison of transitional and post-transitional populations

“…As a result, rapid changes in the age-fertility pattern, i.e. retreating from the early childbearing pattern (Kocourková et al, 2015), occurred in the 1990s (Fig. 2).…”

Herbal fertility treatments used in North America from colonial times to 1900, and their potential for improving the success rate of assisted reproductive technology

“…Moroever, women seeking IVF are facing age restrictions everywhere. For example, the Czech Republic is preparing a new act to regulate ART with an age limit of 45 years for women, but with no limit for Czech men ( Kocourkova et al, 2015 ). Of the 73,406 IVF cycles initiated in the USA in 2000, 6989 (9.5%) were performed in women aged over 40 years, for whom the livebirth rates for 1996, 1997, 1998, 1999 and 2000 were 6.4%, 7.3%, 8.3%, 8.1% and 7.8%, respectively ( Ng and Ho, 2007 ).…”